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Traidl S, Angela Y, Stender A, Kulberg A, Tronnier M, Prenzler NK, Wattjes MP, Kapp A, Stangel M, Schacht V, Werfel T. A rare case of neuro- and otosyphilis in secondary syphilis. J Eur Acad Dermatol Venereol 2021; 35:e823-e826. [PMID: 34242450 DOI: 10.1111/jdv.17512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 05/12/2021] [Accepted: 06/30/2021] [Indexed: 11/26/2022]
Affiliation(s)
- S Traidl
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany.,Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, Hannover, Germany
| | - Y Angela
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - A Stender
- Clinical Neuroimmunology and Neurochemistry, Department of Neurology, Hannover Medical School, Germany
| | - A Kulberg
- Department of Dermatology, Venereology, and Allergolgy, HELIOS Hospital, Hildesheim, Germany
| | - M Tronnier
- Department of Dermatology, Venereology, and Allergolgy, HELIOS Hospital, Hildesheim, Germany
| | - N K Prenzler
- Department of Otorhinolaryngology, Head and Neck Surgery, Hannover Medical School, Hannover, Germany
| | - M P Wattjes
- Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
| | - A Kapp
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - M Stangel
- Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, Hannover, Germany.,Clinical Neuroimmunology and Neurochemistry, Department of Neurology, Hannover Medical School, Germany.,Center for Systems Neuroscience, University of Veterinary Medicine Hannover, Hannover, Germany
| | - V Schacht
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - T Werfel
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany.,Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, Hannover, Germany
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2
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Osmanovic A, Koch M, Müschen L, Seeliger T, Gingele S, Stangel M, Dengler R, Petri S, Skripuletz T, Körner S. P28 Blink R1 latency outcome in patients with chronic acquired demyelinating neuropathy under immunoglobulin treatment. Clin Neurophysiol 2020. [DOI: 10.1016/j.clinph.2019.12.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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3
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Schmidt SB, Boltzmann M, Krauss JK, Stangel M, Gutenbrunner C, Rollnik JD. Standardized nutritional supply versus individual nutritional assessment: Impact on weight changes, complications and functional outcome from neurological early rehabilitation. Clin Nutr 2019; 39:1225-1233. [PMID: 31151820 DOI: 10.1016/j.clnu.2019.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 05/08/2019] [Accepted: 05/10/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND & AIMS Approximately 55% of neurological and neurosurgical early rehabilitation (NNER) patients are in need of enteral nutrition, but long-term nutritional assessment of these critically ill patients is suboptimal. Therefore, this study analyzed the effect of an individual nutritional assessment on weight changes during rehabilitation and impact on complications and functional outcome. METHODS 170 NNER patients on enteral nutrition were enrolled in the study. According to the initial ward, patients were assigned to receive standardized enteral nutrition (n = 107, control group) or an individual nutritional assessment (n = 63, intervention group). Weight changes, complications, assessment of the functional outcome (Early Rehabilitation Index, Barthel Index, Early Rehabilitation Barthel Index) and the length of stay were recorded and compared between groups using non-parametric tests for non-paired samples (Mann-Whitney U test for metric data or the χ2 test for categorical data) or paired samples (Wilcoxon test). In addition, daily energy requirement was calculated and compared with daily intake. Correlation analysis by Spearman was performed to investigate linear relationship between weight changes and the difference of administered and calculated calories in both study groups. RESULTS A weight loss was observed in the control group, whereas the weight of the intervention group remained stable over time. The difference between calculated and administered calories correlated with weight changes in the control group. Regarding complications during rehabilitation, control patients showed more frequently impaired diuresis. In addition, control patients were suffering longer from diarrhea than patients of the intervention group. Both groups improved in functional status to a comparable degree. Relationships between these improvements and weight changes or administered calories could not be found. CONCLUSIONS Individual nutritional assessment had not an additional affect for the improvement of functional outcome or the prevention of complications. However, weight turned out to be more stable and signs of nutritional incompatibilities are less frequent among patients being treated with an individualized nutritional assessment.
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Affiliation(s)
- S B Schmidt
- Institute for Neurorehabilitation Research (InFo), BDH-Clinic Hessisch Oldendorf, Associated Institute of Hannover Medical School, Hessisch Oldendorf, Germany.
| | - M Boltzmann
- Institute for Neurorehabilitation Research (InFo), BDH-Clinic Hessisch Oldendorf, Associated Institute of Hannover Medical School, Hessisch Oldendorf, Germany
| | - J K Krauss
- Hannover Medical School, Dept. of Neurosurgery, Germany
| | - M Stangel
- Hannover Medical School, Dept. of Neurology, Germany
| | - C Gutenbrunner
- Hannover Medical School, Dept. of Physical Medicine and Rehabilitation, Germany
| | - J D Rollnik
- Institute for Neurorehabilitation Research (InFo), BDH-Clinic Hessisch Oldendorf, Associated Institute of Hannover Medical School, Hessisch Oldendorf, Germany
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4
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Aktas O, Wattjes MP, Stangel M, Hartung HP. Diagnose der Multiplen Sklerose: Revision der McDonald-Kriterien 2017. Nervenarzt 2018; 89:1344-1354. [DOI: 10.1007/s00115-018-0550-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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5
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van Schaik IN, Bril V, van Geloven N, Hartung HP, Lewis RA, Sobue G, Lawo JP, Praus M, Mielke O, Durn BL, Cornblath DR, Merkies ISJ, Sabet A, George K, Roberts L, Carne R, Blum S, Henderson R, Van Damme P, Demeestere J, Larue S, D'Amour C, Bril V, Breiner A, Kunc P, Valis M, Sussova J, Kalous T, Talab R, Bednar M, Toomsoo T, Rubanovits I, Gross-Paju K, Sorro U, Saarela M, Auranen M, Pouget J, Attarian S, Le Masson G, Wielanek-Bachelet A, Desnuelle C, Delmont E, Clavelou P, Aufauvre D, Schmidt J, Zschuentssch J, Sommer C, Kramer D, Hoffmann O, Goerlitz C, Haas J, Chatzopoulos M, Yoon R, Gold R, Berlit P, Jaspert-Grehl A, Liebetanz D, Kutschenko A, Stangel M, Trebst C, Baum P, Bergh F, Klehmet J, Meisel A, Klostermann F, Oechtering J, Lehmann H, Schroeter M, Hagenacker T, Mueller D, Sperfeld A, Bethke F, Drory V, Algom A, Yarnitsky D, Murinson B, Di Muzio A, Ciccocioppo F, Sorbi S, Mata S, Schenone A, Grandis M, Lauria G, Cazzato D, Antonini G, Morino S, Cocito D, Zibetti M, Yokota T, Ohkubo T, Kanda T, Kawai M, Kaida K, Onoue H, Kuwabara S, Mori M, Iijima M, Ohyama K, Baba M, Tomiyama M, Nishiyama K, Akutsu T, Yokoyama K, Kanai K, van Schaik I, Eftimov F, Notermans N, Visser N, Faber C, Hoeijmakers J, Rejdak K, Chyrchel-Paszkiewicz U, Casanovas Pons C, Alberti Aguiló M, Gamez J, Figueras M, Marquez Infante C, Benitez Rivero S, Lunn M, Morrow J, Gosal D, Lavin T, Melamed I, Testori A, Ajroud-Driss S, Menichella D, Simpson E, Chi-Ho Lai E, Dimachkie M, Barohn R, Beydoun S, Johl H, Lange D, Shtilbans A, Muley S, Ladha S, Freimer M, Kissel J, Latov N, Chin R, Ubogu E, Mumfrey S, Rao T, MacDonald P, Sharma K, Gonzalez G, Allen J, Walk D, Hobson-Webb L, Gable K. Subcutaneous immunoglobulin for maintenance treatment in chronic inflammatory demyelinating polyneuropathy (PATH): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Neurol 2018; 17:35-46. [DOI: 10.1016/s1474-4422(17)30378-2] [Citation(s) in RCA: 130] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 09/28/2017] [Accepted: 10/02/2017] [Indexed: 10/18/2022]
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6
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Klotz L, Berthele A, Brück W, Chan A, Flachenecker P, Gold R, Haghikia A, Hellwig K, Hemmer B, Hohlfeld R, Korn T, Kümpfel T, Lang M, Limmroth V, Linker RA, Meier U, Meuth SG, Paul F, Salmen A, Stangel M, Tackenberg B, Tumani H, Warnke C, Weber MS, Ziemssen T, Zipp F, Wiendl H. [Monitoring of blood parameters under course-modified MS therapy : Substance-specific relevance and current recommendations for action]. Nervenarzt 2017; 87:645-59. [PMID: 26927677 DOI: 10.1007/s00115-016-0077-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
With the approval of various substances for the immunotherapy of multiple sclerosis (MS), treatment possibilities have improved significantly over the last few years. Indeed, the choice of individually tailored preparations and treatment monitoring for the treating doctor is becoming increasingly more complex. This is particularly applicable for monitoring for a treatment-induced compromise of the immune system. The following article by members of the German Multiple Sclerosis Skills Network (KKNMS) and the task force "Provision Structures and Therapeutics" summarizes the practical recommendations for approved immunotherapy for mild to moderate and for (highly) active courses of MS. The focus is on elucidating the substance-specific relevance of particular laboratory parameters with regard to the mechanism of action and the side effects profile. To enable appropriate action to be taken in clinical practice, any blood work changes that can be expected, in addition to any undesirable laboratory findings and their causes and relevance, should be elucidated.
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Affiliation(s)
- L Klotz
- Department für Neurologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Deutschland
| | - A Berthele
- Neurologische Klinik und Poliklinik, Klinikum rechts der Isar der TU München, Ismaninger Straße 22, 81675, München, Deutschland
| | - W Brück
- Institut für Neuropathologie, Universitätsmedizin Göttingen der Georg-August-Universität, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland
| | - A Chan
- Neurologische Klinik, St. Josef-Hospital, Universitätsklinikum der Ruhr-Universität Bochum, Gudrunstr. 56, 44791, Bochum, Deutschland
| | - P Flachenecker
- Neurologisches Rehabilitationszentrum Quellenhof in Bad Wildbad GmbH, Kuranlagenallee 2, 75323, Bad Wildbad, Deutschland
| | - R Gold
- Neurologische Klinik, St. Josef-Hospital, Universitätsklinikum der Ruhr-Universität Bochum, Gudrunstr. 56, 44791, Bochum, Deutschland
| | - A Haghikia
- Neurologische Klinik, St. Josef-Hospital, Universitätsklinikum der Ruhr-Universität Bochum, Gudrunstr. 56, 44791, Bochum, Deutschland
| | - K Hellwig
- Neurologische Klinik, St. Josef-Hospital, Universitätsklinikum der Ruhr-Universität Bochum, Gudrunstr. 56, 44791, Bochum, Deutschland
| | - B Hemmer
- Neurologische Klinik und Poliklinik, Klinikum rechts der Isar der TU München, Ismaninger Straße 22, 81675, München, Deutschland
| | - R Hohlfeld
- Institut für Klinische Neuroimmunologie, Klinikum der Universität München, Campus Großhadern, Marchioninistr. 15, 81377, München, Deutschland
| | - T Korn
- Neurologische Klinik und Poliklinik, Klinikum rechts der Isar der TU München, Ismaninger Straße 22, 81675, München, Deutschland
| | - T Kümpfel
- Institut für Klinische Neuroimmunologie, Klinikum der Universität München, Campus Großhadern, Marchioninistr. 15, 81377, München, Deutschland
| | - M Lang
- NeuroTransConcept GmbH, Centers of Excellence, Pfauengasse 8, 89073, Ulm, Deutschland
| | - V Limmroth
- Klinik für Neurologie und Palliativmedizin, Kliniken der Stadt Köln, Ostmerheimer Str. 200, 51109, Köln - Merheim, Deutschland
| | - R A Linker
- Neurologische Klinik, Universitätsklinikum Erlangen, Schwabachanlage 6, 91054, Erlangen, Deutschland
| | - U Meier
- Berufsverband Deutscher Neurologen BDN, Am Ziegelkamp 1f, 41515, Grevenbroich, Deutschland
| | - S G Meuth
- Department für Neurologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Deutschland
| | - F Paul
- Institut für Neuroimmunologie, Universitätsklinikum Charité, Schumannstr. 20/21, 10117, Berlin, Deutschland
| | - A Salmen
- Neurologische Klinik, St. Josef-Hospital, Universitätsklinikum der Ruhr-Universität Bochum, Gudrunstr. 56, 44791, Bochum, Deutschland
| | - M Stangel
- Klinik für Neurologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - B Tackenberg
- Klinik für Neurologie, Philipps-Universität und Universitätsklinikum Marburg, Baldingerstr. 1, 35043, Marburg, Deutschland
| | - H Tumani
- Neurologische Universitätsklinik der Universität Ulm, Oberer Eselsberg 45, 89081, Ulm, Deutschland.,Fachklinik für Neurologie Dietenbronn, Dietenbronn 7, 88477, Schwendi, Deutschland
| | - C Warnke
- Klinik für Neurologie, Universitätsklinikum Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland
| | - M S Weber
- Institut für Neuropathologie, Universitätsmedizin Göttingen der Georg-August-Universität, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland
| | - T Ziemssen
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Carl Gustav Carus der TU Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - F Zipp
- Klinik für Neurologie, Universitätsmedizin der Johannes-Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - H Wiendl
- Department für Neurologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Deutschland.
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Herder V, Hansmann F, Stern M, Bicker G, Skripuletz T, Stangel M, Baumgärtner W, Beineke A. Disturbed Neurogenesis in a Toxic Model for Hippocampal Degeneration. J Comp Pathol 2017. [DOI: 10.1016/j.jcpa.2016.11.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
Progressive multifocal leukoencephalopathy (PML) is a disease of immunosuppressed patients caused by the JC polyomavirus (JCPyV). Due to the elevated risk in patients treated with natalizumab for multiple sclerosis (MS) and also treatment with other biologicals for different indications, the relevance of PML has increased in recent years. This article summarizes the published knowledge on the biology and pathogenesis of PML with a focus on the role of cerebrospinal fluid diagnostics in the work-up for PML and the current PML case definition. Current recommendations regarding risk management are discussed, as are possible therapies and prevention.
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Affiliation(s)
- C Warnke
- Klinik für Neurologie, Medizinische Fakultät, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland.
| | - M P Wattjes
- Abteilung für Radiologie und Nuklearmedizin, VU University Medical Center, Amsterdam, Niederlande
| | - O Adams
- Institut für Virologie, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - H-P Hartung
- Klinik für Neurologie, Medizinische Fakultät, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland
| | - R Martin
- Klinik für Neurologie, Universitätsspital Zürich, Zürich, Schweiz
| | - T Weber
- Klinik für Neurologie, Kath. Marienkrankenhaus, Hamburg, Deutschland
| | - M Stangel
- Klinik für Neurologie, Medizinische Hochschule Hannover, Hannover, Deutschland
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9
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Ross S, Witte T, Stangel M, Schmidt R, Baerlecken N. SAT0320 Igg3 Autoantibodies Binding To Stathmin-4 as Marker of Polyneuropathy in Primary Sjögren Syndrome:. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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10
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Hoyos HC, Marder M, Ulrich R, Gudi V, Stangel M, Rabinovich GA, Pasquini LA, Pasquini JM. The Role of Galectin-3: From Oligodendroglial Differentiation and Myelination to Demyelination and Remyelination Processes in a Cuprizone-Induced Demyelination Model. Advances in Experimental Medicine and Biology 2016; 949:311-332. [DOI: 10.1007/978-3-319-40764-7_15] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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11
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Werneburg S, Büttner F, Stangel M, Mühlenhoff M, Hildebrandt H. ISDN2014_0137: NG2 cells and microglia show cell‐type specific expression of polysialic acid attached to different protein carriers. Int J Dev Neurosci 2015. [DOI: 10.1016/j.ijdevneu.2015.04.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- S. Werneburg
- Institute for Cellular ChemistryHannover Medical SchoolHannoverGermany
- Center for Systems Neuroscience (ZSN)HannoverGermany
| | - F.F. Büttner
- Institute for Cellular ChemistryHannover Medical SchoolHannoverGermany
| | - M. Stangel
- Department of NeurologyHannover Medical SchoolHannoverGermany
- Center for Systems Neuroscience (ZSN)HannoverGermany
| | - M. Mühlenhoff
- Institute for Cellular ChemistryHannover Medical SchoolHannoverGermany
| | - H. Hildebrandt
- Institute for Cellular ChemistryHannover Medical SchoolHannoverGermany
- Center for Systems Neuroscience (ZSN)HannoverGermany
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12
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Wostradowski T, Gudi V, Pul R, Gingele S, Lindquist JA, Stangel M, Lindquist S. Effect of interferon-β1b on CXCR4-dependent chemotaxis in T cells from multiple sclerosis patients. Clin Exp Immunol 2015. [PMID: 26212126 DOI: 10.1111/cei.12689] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Multiple sclerosis (MS) is an inflammatory, demyelinating and neurodegenerative disease triggered by infiltration of activated T cells into the central nervous system. Interferon (IFN)-β is an established, safe and effective treatment for patients with relapsing-remitting MS (RRMS). The cytokine can inhibit leucocyte infiltration into the central nervous system; however, little is known about the precise molecular mechanisms. Previously, in vitro application of IFN-β1b was shown to reduce CXCL12/CXCR4-mediated monocyte migration. Here, we analysed the effects of IFN-β1b on CXCR4-dependent T cell function. In vitro exposure to IFN-β1b (1000 U/ml) for 20 h reduced CXCR4-dependent chemotaxis of primary human T cells from healthy individuals and patients with RRMS. Investigating the IFN-β1b/CXCR4 signalling pathways, we found no difference in phosphorylation of ZAP70, ERK1/2 and AKT despite an early induction of the negative regulator of G-protein signalling, RGS1 by IFN-β1b. However, CXCR4 surface expression was reduced. Quantitative real time-PCR revealed a similar reduction in CXCR4-mRNA, and the requirement of several hours' exposure to IFN-β1b supports a transcriptional regulation. Interestingly, T cells from MS patients showed a lower CXCR4 expression than T cells from healthy controls, which was not reduced further in patients under IFN-β1b therapy. Furthermore, we observed no change in CXCL12-dependent chemotaxis in RRMS patients. Our results demonstrate clearly that IFN-β1b can impair the functional response to CXCR4 by down-regulating its expression, but also points to the complex in vivo effects of IFN-β1b therapy.
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Affiliation(s)
- T Wostradowski
- Clinical Neuroimmunology and Neurochemistry, Department of Neurology, Hannover Medical School, Hannover, Germany.,Center for Systems Neuroscience, Hannover, Germany
| | - V Gudi
- Clinical Neuroimmunology and Neurochemistry, Department of Neurology, Hannover Medical School, Hannover, Germany
| | - R Pul
- Clinical Neuroimmunology and Neurochemistry, Department of Neurology, Hannover Medical School, Hannover, Germany
| | - S Gingele
- Clinical Neuroimmunology and Neurochemistry, Department of Neurology, Hannover Medical School, Hannover, Germany
| | - J A Lindquist
- Department of Nephrology, Hypertension, Diabetes and Endocrinology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.,Institute for Molecular and Clinical Immunology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - M Stangel
- Clinical Neuroimmunology and Neurochemistry, Department of Neurology, Hannover Medical School, Hannover, Germany.,Center for Systems Neuroscience, Hannover, Germany
| | - S Lindquist
- Clinical Neuroimmunology and Neurochemistry, Department of Neurology, Hannover Medical School, Hannover, Germany.,Department of Neurochemistry and Molecular Biology, Leibniz-Institute for Neurobiology, and Neurological Rehabilitation Centre, MEDIAN Kliniken, Magdeburg, Germany
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Kolber P, Luessi F, Meuth S, Klotz L, Korn T, Trebst C, Tackenberg B, Kieseier B, Kümpfel T, Fleischer V, Tumani H, Wildemann B, Lang M, Flachenecker P, Meier U, Brück W, Limmroth V, Haghikia A, Hartung HP, Stangel M, Hohlfeld R, Hemmer B, Gold R, Wiendl H, Zipp F. Aktuelles zur Therapieumstellung bei Multipler Sklerose. Nervenarzt 2015; 86:1236-47. [DOI: 10.1007/s00115-015-4368-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Magnetic resonance imaging (MRI) is the most powerful tool for the early (differential) diagnosis of multiple sclerosis (MS) and has been part of the International Panel criteria (2001, 2005, 2010) for more than 10 years. The role of brain and spinal cord MRI in the diagnosis of MS is well established. New MR techniques and markers will further improve the diagnostic value in a research and clinical routine setting. In addition to diagnosis, MRI is widely used for prognostic evaluation as well as treatment efficacy and safety monitoring. This field has gained importance with the introduction of new MS therapeutics. Therefore, the scope of MRI-guided MS disease monitoring has been widened to include rigorous treatment monitoring aiming at "no evidence of disease activity (NEDA)". Next, safety monitoring of treated MS patients has become major concern to enable early detection of opportunistic infections such as progressive multifocal leukoencephalopathy (PML). Driven by these new developments, recently published expert panel guidelines stressed the need for standardized imaging protocols and targeted specialized imaging markers for MS diagnosis and disease monitoring. This review article aims to give an update on the role of MRI in the diagnosis and monitoring of MS with particular emphasis to treatment efficacy and safety, both in clinical practice and in research.
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Affiliation(s)
- M P Wattjes
- MS Center and Department of Radiology & Nuclear Medicine, VU University Medical Centre, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands.
| | - M D Steenwijk
- MS Center and Department of Radiology & Nuclear Medicine, VU University Medical Centre, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands
| | - M Stangel
- Clinical Neuroimmunology and Neurochemistry, Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
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15
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Kremer D, Hartung HP, Stangel M, Küry P. [New therapeutic strategies for remyelination in multiple sclerosis]. Nervenarzt 2015; 86:934-46. [PMID: 26122637 DOI: 10.1007/s00115-014-4249-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Multiple sclerosis (MS) is characterized by oligodendrocyte death and myelin sheath destruction of the central nervous system (CNS) in response to autoinflammatory processes. Besides demyelination axonal degeneration constitutes the second histopathological hallmark of this disease. A large number of immunomodulatory and targeted immunosuppression treatments have been approved for relapsing remitting (RR) MS where they effectively reduce relapse rates; however, currently no treatment options exist to repair injured axonal tracts or myelin damage that accumulates over time particularly in progressive MS. In light of the growing available therapeutic repertoire of highly potent immunomodulatory medications there is an increasing interest in the development of therapies aimed at neutralizing neurodegenerative damage. Endogenous remyelination processes occur mainly as a result of oligodendrocyte precursor cell (OPC) activation, recruitment and maturation; however, this repair activity appears to be limited and increasingly fails during disease progression. Based on these observations OPCs are considered as promising targets for the regenerative treatment of all stages of MS. This article presents an overview of approved medications with a suggested role in regeneration, regenerative treatments that are currently being tested in clinical trials, as well as promising future therapeutic approaches derived from basic glial cell research aiming at the promotion of the endogenous repair activity of the brain.
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Affiliation(s)
- D Kremer
- Neurologische Klinik, Medizinische Fakultät, Heinrich-Heine-Universität, Moorenstr. 5, 40225, Düsseldorf , Deutschland
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Trowbridge IS, Collawn J, Jing S, White S, Esekogwu V, Stangel M. Structure-function analysis of the human transferrin receptor: effects of anti-receptor monoclonal antibodies on tumor growth. Curr Stud Hematol Blood Transfus 2015:139-47. [PMID: 1954762 DOI: 10.1159/000419352] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- I S Trowbridge
- Department of Cancer Biology, Salk Institute, San Diego, Calif
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17
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Abstract
Immunoglobulin (Ig) therapy is the mainstay of treatment for primary antibody deficiency disorders and has proved to be efficacious in specific autoimmune and inflammatory diseases. Additionally, due to the role of Ig in complement activation, it is being used increasingly in solid organ transplantation. Furthermore, Ig is the primary or secondary treatment in some immune-mediated neuropathies such as chronic inflammatory demyelinating polyneuropathy (CIDP) or multifocal motor neuropathy (MMN). This session discusses trends of Ig use in Europe, proposed mechanisms of action, adverse effects and the potential role of Ig therapy in transplantation. Dr Šedivá reported that Ig therapy is available in all European countries, although dosing is not always optimal, due partly to reimbursement plans. Subcutaneous immunoglobulin (SCIg) has become increasingly accessible in recent years; however, the chosen route of administration still varies widely between countries. Dr Berger's presentation on optimization of Ig therapy in neuropathies, and Dr Rojavin's report on a pharmacometric model to determine the serum IgG levels achieved by different dosing regimens in primary antibody deficiency (PAD) patients, led to the challenging concept of using individualized dosing strategies. Dr Klehmet reported on the potential benefit of using antigen-specific T cell responses as a biomarker of IVIg responsiveness in CIDP patients, while Dr von Gunten provided an insight into the mechanisms of action of Ig preparations, suggesting that the immunoregulatory effects of IgG may be mediated by IgG antibodies against glycans. Dr Basta reported on the potential thrombogenic adverse effects associated with Ig therapy. Although these adverse events are rare, further studies are needed to clarify the relationship between Ig replacement and immunomodulatory therapy and these adverse reactions. In transplantation, Dr Carbone described that prophylactic IVIg treatment was found to decrease the incidence of severe infection in IgG hypogammaglobulinaemia patients undergoing heart transplantations. Furthermore, Dr Clatworthy reported that inactivating polymorphisms in the inhibitory receptor FcγRIIB do not impact upon kidney allograft survival.
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Affiliation(s)
- K Warnatz
- Centre for Chronic Immunodeficiencies, Freiburg, Germany
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18
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Abstract
The pan-European survey provides useful information on the accessibility and trends of intravenous and subcutaneous immunoglobulin (IVIg/SCIg) therapy, which is used to treat primary immunodeficiency disorders (PIDs). Although immunoglobulin (Ig) therapy is the first-line treatment for PIDs, the mechanisms of action of Ig therapy may differ according to the condition it is used to treat. Moreover, intriguing presentations suggest that further investigation is required to understand more clearly both the haematological and immunoregulatory effects of therapeutic immunoglobulin. This can ultimately provide more information on optimizing Ig therapy efficacy, and establish whether individualized dosing regimens for patients will be conducive to better clinical outcomes. In addition to treating autoimmune and inflammatory conditions, there is evidence to suggest that immunoglobulins can potentially play a role in transplantation, which warrants further investigation for future use.
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Affiliation(s)
- K Warnatz
- Centre for Chronic Immunodeficiencies, Freiburg, Germany
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19
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Jungwirth N, Hansmann F, Zhang N, Salinas Tejedor L, Skripuletz T, Stangel M, Baumgärtner W. Mesenchymal stem cells: Promising candidates for the treatment of demyelinating diseases? J Comp Pathol 2015. [DOI: 10.1016/j.jcpa.2014.10.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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20
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Hoepner R, Ahlbrecht J, Faissner S, Schneider R, Dahlhaus S, Adams O, Raab P, Lukas C, Chan A, Stangel M, Gold R. Clinical and paraclinical findings in natalizumab-associated infratentorial progressive multifocal leukoencephalopathy patients. J Neurol Neurosurg Psychiatry 2014; 85:1177-8. [PMID: 24700881 DOI: 10.1136/jnnp-2014-307582] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- R Hoepner
- Department of Neurology, St. Josef Hospital Bochum, Ruhr University, Bochum, Germany
| | - J Ahlbrecht
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - S Faissner
- Department of Neurology, St. Josef Hospital Bochum, Ruhr University, Bochum, Germany
| | - R Schneider
- Department of Neurology, St. Josef Hospital Bochum, Ruhr University, Bochum, Germany
| | - S Dahlhaus
- Department of Neurology, St. Josef Hospital Bochum, Ruhr University, Bochum, Germany
| | - O Adams
- Department of Virology, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - P Raab
- Institute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
| | - C Lukas
- Institute of Diagnostic and Interventional Neuroradiology, St. Josef Hospital Bochum, Ruhr University, Bochum, Germany
| | - A Chan
- Department of Neurology, St. Josef Hospital Bochum, Ruhr University, Bochum, Germany
| | - M Stangel
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - R Gold
- Department of Neurology, St. Josef Hospital Bochum, Ruhr University, Bochum, Germany
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21
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Wegner F, Nabavi E, Wilke F, Ben Tayeb S, Boeck AL, Trebst C, Stangel M, Voss E, Schrader C, Ahrens J, Leffler A, Rodriguez-Raecke R, Dengler R, Geworski L, Bengel F, Berding G. Anti-LGI1 and anti-NMDA receptor encephalitis show distinct patterns of brain glucose metabolism in FDG-PET. KLIN NEUROPHYSIOL 2014. [DOI: 10.1055/s-0034-1371187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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22
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Stangel M, Penner I, Kallmann B, Lukas C, Kieseier B, Gold R. Multiple Sclerosis Decision Model (MSDM): Entwicklung eines Mehrfaktorenmodells zur Beurteilung des Therapie- und Krankheitsverlaufs bei schubförmiger Multipler Sklerose. Akt Neurol 2013. [DOI: 10.1055/s-0033-1349643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- M. Stangel
- Klinische Neuroimmunologie und Neurochemie, Neurologische Klinik, Medizinische Hochschule Hannover
| | - I. Penner
- Kognitive Psychologie und Methodologie, Universität Basel, Schweiz
| | | | - C. Lukas
- Institut für diagnostische und interventionelle Radiologie, St. Josef Hospital, Ruhr-Universität Bochum
| | - B. Kieseier
- Neurologische Klinik, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf
| | - R. Gold
- Klinik für Neurologie, St. Josef Hospital, Ruhr-Universität Bochum
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23
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Singh V, Prajeeth CK, Gudi V, Bénardais K, Voss EV, Stangel M. 2-Chlorodeoxyadenosine (cladribine) induces apoptosis in human monocyte-derived dendritic cells. Clin Exp Immunol 2013; 173:288-97. [PMID: 23607690 DOI: 10.1111/cei.12109] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2013] [Indexed: 12/21/2022] Open
Abstract
2-Chlorodeoxyadenosine (cladribine, CdA) is an immunosuppressive drug that is licensed to treat hairy cell leukaemia, and has been shown recently to have beneficial effects in patients with multiple sclerosis (MS). The therapeutic effects of CdA have been suggested to be mediated partly through its potent toxicity towards lymphocytes. However, the effects of CdA on other immune cells are poorly understood. In the present study, we investigated the effects of CdA on the induction of apoptosis in human monocytes, monocyte-derived immature (ImDC) and mature (mDC) dendritic cells. Treatment of monocytes with CdA strongly induced apoptosis after 24 h, while apoptosis induction in DC was evident after 72 h. Furthermore, CdA treatment strongly induced caspase-3 and caspase-9 in monocytes, whereas activation of caspases was undetected in DC. The mitochondrial membrane potential in DC was reduced significantly after CdA treatment. DNA hypodiploid assessment showed fragmented nuclei in DC after CdA treatment together with activation of p53 protein. These results revealed that CdA induces caspase-independent apoptosis in DC and suggest cell type specific effects of CdA. This mechanism may contribute to the effect of CdA in autoimmune diseases.
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Affiliation(s)
- V Singh
- Clinical Neuroimmunology and Neurochemistry, Department of Neurology, Hannover Medical School, Hannover, Germany
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24
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Sommer C, Gold R, Stangel M, Pittrow D, Huscher D, Kirch W, Baumann U, Fasshauer M, Borte M, Reiser M, Hensel M. Behandlung von Patienten mit Multifokaler Motorischer Neuropathie (MMN) mit Immunglobulinen im prospektiven SIGNS-Register. KLIN NEUROPHYSIOL 2013. [DOI: 10.1055/s-0033-1337233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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25
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Harrer A, Tumani H, Niendorf S, Lauda F, Geis C, Weishaupt A, Kleinschnitz C, Rauer S, Kuhle J, Stangel M, Weber F, Uhr M, Linnebank M, Wildemann B, Jarius S, Guger M, Ayzenberg I, Chan A, Zettl U, Wiendl H, Pilz G, Hitzl W, Weber JR, Kraus J. Cerebrospinal fluid parameters of B cell-related activity in patients with active disease during natalizumab therapy. Mult Scler 2012; 19:1209-12. [PMID: 23093485 DOI: 10.1177/1352458512463483] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Recently, the disappearance of oligoclonal bands (OCBs) from the cerebrospinal fluid (CSF) of a few natalizumab-treated patients with multiple sclerosis (MS) has been reported. This is interesting since CSF-restricted OCB are believed to persist in MS. We pooled CSF data from 14 MS centers to obtain an adequate sample size for investigating the suspected changes in central nervous system (CNS)-restricted humoral immune activities in the context of natalizumab therapy. In a retrospective chart analysis, CSF parameters of blood-CSF barrier integrity and intrathecal IgG production from 73 natalizumab-treated MS patients requiring a diagnostic puncture for exclusion of progressive multifocal leukoencephalopathy were compared with CSF data obtained earlier in the course of disease before natalizumab therapy. At the time of repeat lumbar puncture, local IgG production (according to Reibergram) was significantly reduced (p < 0.0001) and OCB had disappeared in 16% of the patients. We therefore conclude that natalizumab therapy interferes with intrathecal antibody production at least in a significant number of patients.
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Affiliation(s)
- A Harrer
- Department of Neurology, Christian-Doppler-Klinik, Paracelsus Medical University, Austria.
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26
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Gold R, Hartung HP, Stangel M, Wiendl H, Zipp F. Therapieziele von Basis- und Eskalationstherapien zur Behandlung der schubförmig-remittierenden Multiplen Sklerose. Akt Neurol 2012. [DOI: 10.1055/s-0032-1305248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- R. Gold
- Neurologische Klinik der Ruhr-Universität, St. Josef Hospital
| | - H.-P. Hartung
- Neurologische Klinik der Heinrich-Heine-Universität Düsseldorf
| | - M. Stangel
- Neurologische Klinik der Medizinischen Hochschule Hannover
| | - H. Wiendl
- Neurologische Klinik der Universität Münster
| | - F. Zipp
- Neurologische Klinik der Johannes Gutenberg-Universität Mainz
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27
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Lindquist S, Stangel M. Stabilisierung unter Interferon β-1b bei Multipler Sklerose mit spätem Erkrankungsbeginn. Akt Neurol 2012. [DOI: 10.1055/s-0032-1304881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- S. Lindquist
- Klinische Neuroimmunologie und Neurochemie, Klinik für Neurologie an der Medizinischen Hochschule Hannover
| | - M. Stangel
- Klinische Neuroimmunologie und Neurochemie, Klinik für Neurologie an der Medizinischen Hochschule Hannover
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28
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Borte M, Baumann U, Pittrow D, Hensel M, Faßhauer M, Huscher D, Reiser M, Stangel M, Gold R, Kirch W. Anwendung von Immunglobulinen bei primären und sekundären Immundefekten und neurologischen Autoimmunerkrankungen. Dtsch Med Wochenschr 2012; 137:675-80. [DOI: 10.1055/s-0032-1304844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- M. Borte
- Fachbereich Pädiatrische Rheumatologie, Immunologie und Infektiologie am Klinikum St. Georg gGmbH Leipzig
| | - U. Baumann
- Klinik für Pädiatrische Pneumologie, Allergologie und Neonatologie, Medizinische Hochschule Hannover
| | - D. Pittrow
- Institut für Klinische Pharmakologie, Medizinische Fakultät, Technische Universität Dresden
| | - M. Hensel
- Mannheimer Onkologie Praxis, Mannheim
| | - M. Faßhauer
- Fachbereich Pädiatrische Rheumatologie, Immunologie und Infektiologie am Klinikum St. Georg gGmbH Leipzig
| | - D. Huscher
- Epidemiologie, Rheumaforschungszentrum Berlin
| | - M. Reiser
- PIOH - Praxis Internistische Onkologie, Hämatologie, Köln, Germany
| | - M. Stangel
- Klinik für Neurologie, Medizinische Hochschule Hannover
| | - R. Gold
- Klinik für Neurologie, St. Josef-Hospital, Klinikum der Ruhr-Universität Bochum
| | - W. Kirch
- Institut für Klinische Pharmakologie, Medizinische Fakultät, Technische Universität Dresden
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29
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Herder V, Hansmann F, Stangel M, Skripuletz T, Baumgärtner W, Beineke A. Lack of cuprizone-induced demyelination in the murine spinal cord despite oligodendroglial alterations substantiates the concept of site-specific susceptibilities of the central nervous system. Neuropathol Appl Neurobiol 2012; 37:676-84. [PMID: 21366663 DOI: 10.1111/j.1365-2990.2011.01168.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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30
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Stangel M, Kieseier B. Neue Entwicklungen bei CIDP und MMN. Akt Neurol 2011. [DOI: 10.1055/s-0031-1287810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- M. Stangel
- Abteilung Klinische Neuroimmunologie und Neurochemie
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31
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Gold R, Linker RA, Stangel M. Fumaric acid and its esters: an emerging treatment for multiple sclerosis with antioxidative mechanism of action. Clin Immunol 2011; 142:44-8. [PMID: 21414846 DOI: 10.1016/j.clim.2011.02.017] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2011] [Revised: 02/17/2011] [Accepted: 02/18/2011] [Indexed: 11/17/2022]
Abstract
Fumaric acid was originally therapeutically used in psoriasis. Several lines of evidence have demonstrated immunomodulatory but also neuroprotective effects for FAE. Clinical studies in psoriasis showed a reduction of peripheral CD4+ and CD8+ T-lymphocytes due to the ability of FAE to induce apoptosis. In vitro studies with the ester dimethylfumarate (DMF) described an inhibitory effect on nuclear factor kappa B (NF-κB)-dependent transcription of tumor necrosis factor-alpha (TNF-α) induced genes in human endothelial cells. Animal experiments in the mouse model of central nervous system demyelination, MOG-induced experimental autoimmune encephalomyelitis, revealed a clear preservation of myelin and axonal density in the plaque. Molecular studies showed that this is based on the antioxidative mechanism of action via induction of the transcription factor Nrf-2. A phase II clinical trial in relapsing-remitting multiple sclerosis (RRMS) patients with dimethylfumarate showed a significant reduction in the number of gadolinium enhancing lesions after 24weeks.
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Affiliation(s)
- R Gold
- Department of Neurology, St. Josef-Hospital/Ruhr-University Bochum, Bochum, Germany.
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32
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Hartung H, Berger J, Wiendl H, Meier U, Stangel M, Aktas O, Kieseier B, Radü EW, Buttmann M, Gold R. Therapie der Multiplen Sklerose mit monoklonalen Antikörpern: aktualisierte Empfehlungen zum Umgang mit Natalizumab im Rahmen eines Expertenmeetings. Akt Neurol 2011. [DOI: 10.1055/s-0030-1266063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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33
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Koutsoudaki PN, Hildebrandt H, Gudi V, Skripuletz T, Škuljec J, Stangel M. Remyelination after cuprizone induced demyelination is accelerated in mice deficient in the polysialic acid synthesizing enzyme St8siaIV. Neuroscience 2010; 171:235-44. [PMID: 20833231 DOI: 10.1016/j.neuroscience.2010.08.070] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2010] [Revised: 08/29/2010] [Accepted: 08/31/2010] [Indexed: 11/30/2022]
Abstract
Polysialic acid (PSA) is a carbohydrate polymer added post-translationally on the neural cell adhesion molecule (NCAM) affecting its adhesion properties. It has been suggested that the presence of PSA in demyelinated lesions in multiple sclerosis could prevent axon-glia interactions inhibiting spontaneous remyelination. The enzyme St8siaIV is one of the two polysialyltransferases responsible for PSA synthesis, and it is predominantly active during adult life. Here we treated 8-10-weeks old St8siaIV deficient and wild-type mice for 5 weeks with cuprizone, which is a reliable model for de- and remyelination in the corpus callosum and cortex. Developmental myelination of the St8siaIV knock-out mice was not disturbed and adult mice showed normal myelin protein expression. Demyelination did not differ between transgenic and wild-type mice but early myelin protein re-expression and thus remyelination were accelerated in St8siaIV knock-out mice during the first week after withdrawal of the toxin. This was mainly due to enhanced oligodendrocyte precursor cells (OPC) differentiation and to a lesser extent to OPC recruitment. These data are proof of principle that PSA expression interferes at least to some extent with remyelination in vivo.
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Affiliation(s)
- P N Koutsoudaki
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Street-1, 30625 Hanover, Germany
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34
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Moharregh-Khiabani D, Stangel M. BG-12. DRUG FUTURE 2010. [DOI: 10.1358/dof.2010.35.2.1424268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
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35
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36
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Pul R, Kopadze T, Skripuletz T, Voss E, Kieseier B, Stangel M. Polyclonal immunoglobulins (IVIg) induce expression of MMP-9 in microglia. J Neuroimmunol 2009; 217:46-50. [DOI: 10.1016/j.jneuroim.2009.09.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2009] [Revised: 08/31/2009] [Accepted: 09/23/2009] [Indexed: 10/20/2022]
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37
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Bußmann JH, Skripuletz T, Gudi V, Koutsoudaki P, Pul R, Moharregh-Khiabani D, Lindner M, Stangel M. De- und Remyelinisierung des Kleinhirnkortex im Cuprizone Mausmodell. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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38
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Bolat S, Berding G, Zajaczek J, Dengler R, Stangel M, Trebst C. F18-Fluordeoxyglucose-Positronen-Emissions-Tomografie (FDG-PET) als sinnvolles diagnostisches Hilfsmittel bei Neurosarkoidose. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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39
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Kempcke R, Chan A, Haas J, Hartung HP, Koehler J, Meier U, Nelles G, Pöhlau D, Putzki N, Stangel M, Ziemssen T, Pieper L. Versorgungsstrukturelle Besonderheiten: Multiple Sklerose in Dresden und Ostsachsen. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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40
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Chan A, Haas J, Hartung HP, Koehler J, Meier U, Nelles G, Pöhlau D, Putzki N, Stangel M, Pieper L, Ziemssen T. Versorgungsstrukturelle Besonderheiten: Multiple Sklerose im Großraum Bochum. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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41
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Ziemssen T, Chan A, Haas J, Hartung HP, Koehler J, Meier U, Nelles G, Pöhlau D, Putzki N, Stangel M, Pieper L. Variabilität und Konvergenz regionaler Versorgungsstrukturen: ein 3-Regionen Vergleich. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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42
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Koehler J, Chan A, Haas J, Hartung HP, Meier U, Nelles G, Pöhlau D, Putzki N, Stangel M, Pieper L, Ziemssen T. Versorgungsstrukturelle Besonderheiten: Multiple Sklerose in der Region Hamburg. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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43
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Voss E, Stangel M. Verzögerte Diagnosestellung und Therapieeinleitung aufgrund atypischer Erstmanifestation einer Multiplen Sklerose. Akt Neurol 2009. [DOI: 10.1055/s-0029-1220411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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44
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Garde N, Skripuletz T, Pul R, Trebst C, Stangel M. Cyclophosphamidtherapie bei Patienten mit sekundär chronisch progredienter Multipler Sklerose nach erfolgloser Mitoxantrontherapie. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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45
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Skripuletz T, Pul R, Wurster U, Peest D, Dengler R, Stangel M. Minimale Symptome und guter Verlauf trotz ZNS Beteiligung eines Marginalzonen B-Zell Lymphoms. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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46
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Stangel M, Hartung HP, Gold R, Kieseier BC. [The significance of intravenous immunoglobulin in treatment of immune-mediated polyneuropathies]. Nervenarzt 2009; 80:678-687. [PMID: 19139838 DOI: 10.1007/s00115-008-2631-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Long-term treatment of immune-mediated polyneuropathies remains difficult. For acute polyneuritis, or Guillain-Barré syndrome, the established standard therapy utilizes high doses of polyvalent intravenous immunoglobulins (IVIG). A recently published randomized placebo-controlled study of patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) showed IVIG to be clinically effective also for this disorder in both short and long term. This survey presents data of this so-called ICE study ("Intravenous immune globulin for the treatment of chronic inflammatory demyelinating polyradiculoneuropathy"). It also discusses the value of IVIG in the treatment of immune-mediated polyneuropathies.
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Affiliation(s)
- M Stangel
- Klinik für Neurologie, Medizinische Hochschule Hannover, Hannover, Deutschland
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Ragancokova D, Jahn K, Kotsiari A, Schlesinger F, Haastert K, Stangel M, Petri S, Krampfl K. Analysis of neuroprotective effects of valproic acid on primary motor neurons in monoculture or co-cultures with astrocytes or Schwann cells. Cell Mol Neurobiol 2009; 29:1037-43. [PMID: 19330445 DOI: 10.1007/s10571-009-9393-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2008] [Accepted: 03/10/2009] [Indexed: 11/25/2022]
Abstract
Chronic dysregulation of the intracellular Ca(2+) homeostasis (excitotoxicity) is thought to contribute to the development of motor neuron diseases. Valproic acid (VPA) is widely used as an antiepileptic drug and acts mainly by inhibition of sodium channels and by enhancing the level of the inhibitory neurotransmitter gamma-aminobutyric acid. Neuroprotective capacities of VPA are supposed to arise also from the inhibition of histone deacetylases. We investigated the viability of highly purified rat embryonic motor neurons cultured on glial feeder layers, composed of either astrocytes or Schwann cells, or in the absence of glia, monoculture in presence of VPA and/or kainate (KA) using immunocytochemistry and calcium imaging. A significant effect of the culture and co-culture conditions on the viability of motor neurons in our in vitro model of excitotoxicity was detected. The neuroprotective effect of VPA on primary embryonic motor neuron cultures was not proven. A functional interaction between VPA and KA occurred during the first 10 days in culture.
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Affiliation(s)
- D Ragancokova
- Department of Neurology and Clinical Neurophysiology, Hannover Medical School, OE 7210, 30625 Hannover, Germany.
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Moharregh-Khiabani D, Linker R, Gold R, Stangel M. Fumaric Acid and its esters: an emerging treatment for multiple sclerosis. Curr Neuropharmacol 2009; 7:60-4. [PMID: 19721818 PMCID: PMC2724664 DOI: 10.2174/157015909787602788] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2008] [Revised: 09/26/2008] [Accepted: 09/30/2008] [Indexed: 01/07/2023] Open
Abstract
Fumaric acid is an intermediate product of the citric acid cycle that is a source of intracellular energy in the form of adenosine triphosphate (ATP). It is generated by oxidation of adenylsuccinate by the enzyme succinate dehydrogenase and is then converted to maleate by the enzyme fumarase. At present, fumaric acid esters (FAE) are licensed for the treatment of psoriasis. Several lines of evidence have demonstrated immunomodulatory effects for FAE. Clinical studies in psoriasis showed a reduction of peripheral CD4(+)- and CD8(+)-T-lymphocytes due to the ability of FAE to induce apoptosis. In vitro studies with the ester dimethyl fumarate (DMF) described an inhibitory effect on nuclear factor kappa B (NF-kappaB)-dependent transcription of tumor necrosis factor-alpha (TNF-alpha) induced genes in human endothelial cells. Animal studies using a model of central nervous system demyelination, MOG-induced experimental autoimmune encephalomyelitis (EAE), revealed a reduction of microglia and macrophages in inflamed lesions. A phase II clinical study in relapsing-remitting multiple sclerosis (RRMS) patients with a modified fumaric acid ester, BG-12, showed as "proof of principle" a significant reduction in the number of gadolinium enhancing lesions after 24 weeks of treatment as compared to placebo. Further phase III studies have now started to explore the long-term efficacy of FAE.
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Affiliation(s)
- D Moharregh-Khiabani
- Department of Neurology, Medical School Hannover, Carl-Neuberg-Strasse 1, D-30625 Hannover, Germany
| | - R.A Linker
- Department of Neurology, St. Josef-Hospital/Ruhr-University Bochum, Gudrunstrasse 56, D-44791 Bochum, Germany
| | - R Gold
- Department of Neurology, St. Josef-Hospital/Ruhr-University Bochum, Gudrunstrasse 56, D-44791 Bochum, Germany
| | - M Stangel
- Department of Neurology, Medical School Hannover, Carl-Neuberg-Strasse 1, D-30625 Hannover, Germany
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Werry C, Götz F, Wurster U, Stangel M, Giess R, Heidenreich F, Windhagen A. Paraneoplastic autoimmune encephalitis associated with CV2/CRMP-5 IgG antineuronal antibodies in a patient with thymoma. J Neurol 2009; 256:129-31. [PMID: 19267170 DOI: 10.1007/s00415-009-0826-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2007] [Revised: 10/17/2007] [Accepted: 11/26/2007] [Indexed: 12/13/2022]
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